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Summary@#The French Society of ENT and Head Neck Surgery（SFORL）present the guidelines on the roles of the various treatment options in childhood obstructive sleep apnea in May 2018，this paper is the interpretation of the guidelines.
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The French Society of ENT and Head Neck Surgery（SFORL）present the guidelines on the roles of the various treatment options in childhood obstructive sleep apnea in May 2018，this paper is the interpretation of the guidelines.
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OBJECTIVE To investigate the value of rigid bronchoscope combined with fiber bronchoscope application in children with airway obstruction.METHODS Retrospective analysis of 176 cases children with airway obstruction from January 1, 2006 to January1, 2016, all patients were diagnosised and treated in our hospital. RESULTS All children were acceptted rigid bronchoscopy combined with fiber bronchoscope under general anesthesia, then received the different thrapy according to the different causes. 104 patients with airway foreign body were all obtained satisfactory effect, 2 cases of children with bronchial foreign body(cap) inspection, failed to remove and contact thoracic surgery doctors to remove the foreign body by thoracotomy. 10 plastic bronchitis patients improved after treatment or cured. 7 cases of bronchial tuberculosis were cured after treatment. 4 patients with airway tumor after minimally invasive surgery, obtained good effect, 2 cases were turned to the other cancer hospital. 2 cases of patients with tracheal stenosis, the symptom is reduced after expansion. Bronchial granulation, tracheomalacia, bronchial softening, bronchial atresia patients improved after treatment. This group of all patients with pneumonia were cured after symptomatic treatment.CONCLUSION Rigid bronchoscopy and fiber bronchoscope are both useful for diagnosis and treatment of children with airway obstruction, both have its advantages and disadvantages, combined application can improve the accuracy of disease diagnosis and timely intervention on the patients.
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OBJECTIVE This study was conducted to analyze the underlying bacterial pathogens of the tonsils and adenoids in children with sleep-disordered breathing(SDB).METHODS The core tissue from the tonsils and/or adenoids of 163 SDB children was cultured aerobically. Of the 163 cases, 120 children underwent adenoidectomy and tonsillectomy simultaneously(A+T), 39 children underwent adenoidectomy(A) and 4 tonsillectom(T) only. 124 children who underwent tonsillectomy were subdivided into two groups based on history(with or without a history of recurrent tonsillitis). 71 children with the history were enrolled in the 'recurrent tonsillitis group' and 53 children without the history were enrolled in 'non- recurrent tonsillitis group'.RESULTS Of the total 120 cases who underwent A+T, 114(95.00%) cases had same distribution of bacteria detected in both sides in the same patient. Besides this, 17 cases in whom mixed organisms were identified in both sites shared common pathogen. No significant difference in the detection rates of staphylococcus aureus and haemophilus influenzae were found when we compared seasons(Tonsil:χ2=8.538,P=0.201; Adenoid:χ2=5.427, P=0.490). No significant difference in the type and detection rate of essential bacteria was found when we compared between recurrent tonsillitis group and 'non-recurrent tonsillitis group' (χ2=3.028,P=0.387).CONCLUSION The bacterial isolates from the tonsils and adenoids are virtually identical in type and detection rate in the same SDB patient. The bacterial distribution of the tonsillar and adenoidal core is unaffected by the seasonal variation and history of recurrent tonsillitis.
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Objective To investigate the red blood cell distribution width (RDWC)and serum leptin (Leotin)levels in pa-tients with early onset coronary heart disease (CHD)and their correlation.Methods From January 2013 to April 2016,320 cases of hospitalized patients with chest pain,chest tightness in the cardiovascular department of the Gaoming District People's Hospital of Foshan City,Guangdong Province,were examined by coronary artery.Of which 240 cases were male under 55 years old,female under 65 years old patients with coronary heart disease (coronary heart disease group),another 80 cases of normal coronary angiography and treadmill negative males under 5 5 years old,female under 6 5 years old patients,as the con-trol group.Gensini score in patients with premature coronary heart disease was calculated according to the coronary artery imaging results,Comparison between the two groups of red blood cell distribution width and serum leptin levels were differ-ent,analysis of red blood cell distribution width and serum leptin levels and the correlation between the degree of coronary artery lesions.Results The red blood cell distribution width and the serum leptin level in patients with early onset coronary heart disease were (13.87 ± 0.31)% and (12.24 ± 2.21)μg/L,significantly higher than the control group (14.31 ± 0.22)% and (9.21±1.78)μg/L (t=11.742,11.116,P<0.001).And Gensini score was positively correlated with coro-nary artery (r=0.413,0.124,P=0.000,0.041).Correlation of red cell distribution width and serum leptin levels were posi-tively (r=0.107,P=0.008).The research object curve the predictive value of red cell distribution width in patients with premature coronary heart disease (ROC)analysis showed that the area of ROC curve of red cell distribution width (AUC) under 0.725(95%CI:0.679~0.764),red cell distribution width value 12.85%,the sensitivity was 68.1%,specificity was 65.4%.Conclusion In patients with premature coronary heart disease,the red blood cell distribution width and serum leptin levels were significantly increased,and was positively correlated with the degree of coronary artery disease,can be used as an independent predictor of premature coronary heart disease.
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<p><b>OBJECTIVE</b>To analyse the correlation between tone burst auditory brainstem response (tone burst auditory brainstem response, tb-ABR) and CE-Chirp voice evoked auditory steady-state response (auditory steady-state response, CE-Chirp ASSR) in infants with profound sensorineural hearing loss.</p><p><b>METHODS</b>A total of 45 infants with profound sensorineural hearing loss underwent threshold tone burst ABR and CE-Chirp ASSR of the frequency response test, response thresholds were recorded in 0.5, 1.0, 2.0 and 4.0 kHz. Whether there was correlation or not existed between two methods were analyzed, SPSS 11.0 statistics software was used.</p><p><b>RESULTS</b>Tone burst ABR and CE-Chirp ASSR could lead to different degrees of threshold in each frequency. Response e elicited threshold percentage mainly concentrated in the 91-100 dBnHL, correlation coefficient between 500-4 000 Hz response threshold elicited rate were: 0.837, 0.913, 0.909, and 0.919, respectively (P < 0.001). The difference of the frequency response threshold test between CE-Chirp ASSR and tone burst ABR were not significant (P > 0.05, Chi square).</p><p><b>CONCLUSIONS</b>The tone burst ABR and CE-Chirp ASSR each frequency have different levels of residual hearing in infants with profound sensorineural hearing loss diagnosed by Click ABR, good correlation exists between tone burst ABR and CE-Chirp ASSR.</p>
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Humans , Infant , Acoustic Stimulation , Methods , Auditory Threshold , Evoked Potentials, Auditory, Brain Stem , Hearing , Hearing Loss, Sensorineural , Diagnosis , Hearing TestsABSTRACT
Objective To investigate the clinical application of the coblation in the treatment of the infant with sleep-disordered breathing. Methods The clinical data were reviewed from 161 infants, who had the cobtilaon tonsillectomy and/or adenoidectomy sugeries in our hospital from January , 2008 to June, 2012. Among the 161 SDB cases, there were 85 obstructive sleep apnea hypopnea syndrom cases and 76 primary snoring cases. After 12 months, the follow-up visit is cut off in January, 2013. Successful follow-ups had been done to 161 infant with SDB. And the clinical efficacy and the occurrence of the complications were investigated. Results the intra-operative blood loss was 10 mL or less. 2(1.24%) were delayed hemorrhage with less pain afteroperation. One year after the surgery, there were 141 cured (87.6%), 15 with apparent effects (9.3%), 3 with effective results (1.9%), 2 with no effect(1.2%)and the total effective rate is 98.8%. Conclusion It is minimally invasive, safe and effective to use coblation to remove tonsil and adenoid in the treatment of infants with sleep-disordered breathing.
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OBJECTIVE@#To explore the characteristics of post-operative pain following coblation tonsillectomy and/or adenoidectomy in children with sleep-disordered breathing (SDB) and explore the correlation between the first day post-operative pain scores and age and operating time.@*METHOD@#1) A total of 113 SDB children scheduled to undergo coblation tonsillectomy and/or adenoidectomy were recruited. 113 children were divided into two groups according to the method of operation, children who underwent coblation tonsillectomy and adenoidectomy were enrolled in study group one and children who underwent coblation adenoidectomy only were in study group two. Be sides, children of study group one with a history of chronic tonsillitis were in chronic tonsillitis group, children without a history of chronic tonsillitis were in non-chronic tonsillitis group. 2) The parents scored pain in their children on a VAS (anchored by "no pain" at 0 and "worst pain" at 10) in the morning, before using any analgesics and having breakfast, over the first 3 and the seventh post-operative days. 3) Post-operative pain scores were compared between both the study group one and two and chronic tonsillitis group and non-chronic tonsillitis group. Futhermore, the correlation between the first day post-operative pain scores and age and operating time were also analysed.@*RESULT@#1) The difference of post-operative pain scores over the first 3 and the seventh post-operative days were significant between the study group one and group two (P0.05). 3) The first day post-operative pain scores was correlated with age (r=0.273, P<0.01) and operating time (r=0.423, P<0.01).@*CONCLUSION@#The first day post-operative pain scores was correlated with age and operating time. Children with a history of chronic tonsillitis were more painful than children without the history.
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Child , Child, Preschool , Female , Humans , Male , Adenoidectomy , Methods , Hypothermia, Induced , Pain Measurement , Pain, Postoperative , Sleep Apnea Syndromes , General Surgery , Tonsillectomy , MethodsABSTRACT
OBJECTIVE@#To compare low temperature coblation assisted tonsillectomy with conventional dissection tonsillectomy intra-operation and after-operation.@*METHOD@#Ninety-two pedia-patients were randomly divided into coblation-assisted tonsillectomy group and the control group. Arthrocine EVac 70 T&A Wand was used for coblation-assisted tonsillectomy, and the energy set was 7. Conventional dissection tonsillectomy was operated in control group. The operating time,bleeding,tonsillar fossae healing and return to normal diet and activities, intraoperative complications were recorded separately. Postoperative pain of the pedia-patients was recorded daily using Wong Baker FACES pain scale for 10 days of after-operation.@*RESULT@#Coblation assisted group had a shorter operative time than the control group (10.2 min vs. 36.5 min, P<0.001). The average amount of intraoperative bleeding of Coblation assisted group was (6.83+/-3.36) ml, while the control group was (30.07+/-7.04) ml. Pedia-patients of Coblation group had a better pain score on 1, 2, 3 days after operation than in control group, and there was no statistically significant difference on 4 to 10 days between the two groups. Coblation group ones returned to normal diet earlier than the control group, but both group required similar time returned to normal activities. There was one patient in control group,who required suturing to stop bleeding for active oropharyngeal bleeding on the 6th day after operation.@*CONCLUSION@#Comparing with traditional dissection, Coblation assisted tonsillectomy is easy to perform with less intraoperative bleeding, shorter operation time, earlier return to normal diet, less pain on 1st to 3rd day postoperatively.
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Adolescent , Child , Child, Preschool , Female , Humans , Male , Cold Temperature , Cryosurgery , Methods , Dissection , Methods , Tonsillectomy , Methods , Tonsillitis , General Surgery , Treatment OutcomeABSTRACT
Objective:To compare low temperature coblation assisted tonsillectomy with conventional dissec-tion tonsillectomy intraoperation and afteroperation. Method:Ninty-two pedia-patients were randomly divided into coblation-assisted tonsillectomy group and the control group. Arthrocare EVac 70 T&.A Wand was used for cobla-tion-assisted tonsillectomy, and the energy set was 7. Conventional dissection tonsillectomy was operated in control group. The operating time,bleeding,tonsillar fossae healing and return to normal diet and activities, intraoperative complications were recorded seperately. Postoperative pain of the pedia-patients was recorded daily using Wong Baker FACES pain scale for 10 days of afteroperation. Result: Coblation assisted group had a shorter operative time than the control group (10. 2min vs. 36. 5min, P<0. 001). The average amount of intraoperative bleeding of Coblation assisted group was(6. 83±3. 36) ml, while the control group was(30. 07±7. 04)ml. Pedia-patients of Coblation group had a better pain score on 1, 2, 3 days after operation than in control group, and there was no statistically significant difference on 4 to 10 days between the two groups. Coblation group ones returned to normal diet earlier than the control group, but both group required similar time returned to normal activities. There was one patient in control group, who required suturing to stop bleeding for active oropharyngeal bleeding on the 6th day after operation. Conclusion: Comparing with traditional dissection, Coblation assisted tonsillectomy is easy to perform with less intraoperative bleeding,shorter operation time,earlier return to normal diet, less pain on 1st to 3th day postoperatively.
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OBJECTIVE@#To investigate the characteristics of heart rate (HR) and heart rhythm in children with obstructive sleep apnea-hypopnea syndrome (OSAHS).@*METHOD@#Ninety-five patients underwent overnight PSG for clinically suspected OSAHS. According to the apnea index (AI), the patients were assigned to control group (AI 92%, n = 27) or OSAHS group (AI > 1/h, SaO2 < 92%, n = 68). The HR and heart rhythm were monitored and compared between the two groups.@*RESULT@#The maximum HR during sleep was significantly higher in OSAHS group while the minimum HR was significantly lower during sleep. Bradycardia and tachycardia is a common feature of pediatric OSAHS. There was a significantly higher incidence of tachycardia in OSAHS groups than in the control group.@*CONCLUSION@#These findings suggest that pediatric OSAHS might influence HR and heart rhythm.
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Child , Child, Preschool , Female , Humans , Male , Electrocardiography , Heart Rate , Polysomnography , Sleep Apnea, ObstructiveABSTRACT
OBJECTIVE To study the relationship between the level of high sensitive C-reactive protein (hs-CRP)and obstructive sleep apnea/hypopnea syndrome(OSAHS)in children. METHODS Between 2008 and 2009, 30 children who were diagnosed OSAHS, were enrolled in OSAHS group. Thirty children with a history of chronic tonsillitis made up chronic tonsillitis group. Thirty children(27 children were diagnosed accessory auricle and 3 children with laryngeal web)consisted of the control group. The three groups were matched by age, sex and BMI. Children in OSAHS group underwent overnight polysomnography monitoring in our medicine sleep center. Samples for plasma hs-CRP level were collected in the morning. RESULTS 1. The difference of plasma hs-CRP level among three groups was not significant (?2=0.179,P=0.914). 2. Plasma hs-CRP level did not correlated with AHI, BMI and lowest saturation of blood oxygen(rs=0.343, 0.104 and-0.062; P=0.064, 0.584, and 0.747, respectively). CONCLUSION Higher hs-CRP values were not observed in children with OSAHS. There are no correlation between hs-CRP and AHI, BMI and lowest saturation of blood oxygen.
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Objective To explore the characteristics of auditory brainstem response(ABR) in children with otitis media with effusion(OME) before and after myringotomy with grommet insertion and the significance of ABR in diagnosing OME.Methods ABR were recorded in 50 cases(100 ears) before receiving myringotomy with grommet insertion for OME,30 cases(60 ears) underwent ABR monitoring after surgery again.For comparison,50 age-matched healthy children(100 ears) were also tested with ABR.Furthermore,30 cases were divided into two groups according to the viscidity of tympanic cavity secretion and the response threshold of wave Ⅴ were compared between the two groups.Results The response threshold of wave Ⅴand the peak latency of wave Ⅰwere normal in 13 percent of 50 cases(100 ears) before surgery.The rate of missed diagnosis was 13%.Among 50 cases,41% had normal response threshold for wave Ⅴ,52% had slight abnormal responses of thresholds of wave Ⅴ and 7% had medium response threshold of wave Ⅴ.The peak latency of wavs Ⅰwas normal in 19% OME children,but it prolonged in 72% OME children and absent in 9% OME children.The prolonged peak latencies(waves Ⅰ,Ⅲ andⅤ) and eleveted response thresholds of wave Ⅴ and shorted transmission time between waves(Ⅰ-Ⅲ andⅠ-Ⅴ) significant when compared to the control group.After surgery,the response thresholds of wave Ⅴand the peak latency of wave Ⅰwere normal in 46.7% children,the response threshold of wave Ⅴ were normal in 70.5% and slight abnormal in 29.5%.Occuring(elicit) rate of wave Ⅰwas 100% and peak latency of wave Ⅰwas normal in 50.2% chilren.The differrence of peak latencies(waves Ⅰ,Ⅲ andⅤ) and the response threshold of wave Ⅴ before surgery